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Finite versus Indefinite Nucleos(t)ide Analogue Therapy of Patients with Chronic Hepatitis B Exhibiting Negative

Haixia Sun1, Yinhui Liu2, Yufeng Zhang1

  • 1Department of Infectious Diseases, The Third Affiliated Hospital of Zhongshan University, No. 600 Tianhe Road, Guangzhou, 510000 Guangdong, China.

Biomed Research International
|July 25, 2022
PubMed

Insights

Discontinuing nucleos(t)ide analogue (NUC) therapy for chronic hepatitis B (CHB) may be safe when HBsAg levels drop below 0.05 IU/mL. Short-term consolidation therapy, less than one year, appears sufficient to prevent relapse.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic hepatitis B (CHB) is a significant global health concern.
  • Nucleos(t)ide analogue (NUC) therapy is a cornerstone in managing CHB.
  • Assessing criteria for finite NUC therapy cessation is crucial for optimizing treatment duration and patient management.

Purpose of the Study:

  • To evaluate if a serum hepatitis B surface antigen (HBsAg) level below 0.05 IU/mL can serve as a criterion for discontinuing finite NUC therapy in CHB patients.
  • To compare the long-term outcomes of finite versus indefinite NUC therapy in patients achieving low HBsAg levels.
  • To determine the optimal duration of consolidation therapy after achieving low HBsAg levels before NUC cessation.

Main Methods:

  • Retrospective analysis of 6715 CHB patients treated between January 1998 and May 2016.
  • Inclusion criteria: patients with HBsAg levels < 0.05 IU/mL.
  • Comparison of outcomes between finite (n=31) and indefinite (n=40) NUC therapy groups, with subgroup analysis of consolidation therapy duration in the finite group.

Main Results:

  • Baseline characteristics were similar between finite and indefinite NUC therapy groups at the time of HBsAg decline to < 0.05 IU/mL.
  • No viral breakthrough or relapse occurred in any patient during a median follow-up of 120 weeks.
  • Long-term outcomes showed no significant differences between finite and indefinite therapy groups, nor between short-term (<1 year) and long-term (>1 year) consolidation therapy groups.

Conclusions:

  • Hepatitis B surface antigen (HBsAg) levels < 0.05 IU/mL may indicate suitability for discontinuing nucleos(t)ide analogue (NUC) therapy in chronic hepatitis B (CHB) patients.
  • Consolidation therapy for less than one year appears adequate to maintain virologic control and prevent relapse after NUC cessation.
  • These findings support the potential for finite NUC therapy regimens guided by HBsAg levels.
Abstract

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